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Anthem Blue Cross CaliforniaCare Plus HMO
The Anthem Blue Cross CaliforniaCare Plus HMO offers comprehensive coverage for a wide range of health care
services. Benefits are payable only when you use Anthem Blue Cross HMO providers and facilities.* There are no
deductibles and no claim forms. You pay a $15 co-pay for most services. The calendar year out-of-pocket co-pay
maximum is $1,000 per person and $3,000 per family.
You must choose a primary care physician (PCP) from a
Participating Medical Group or Independent Practice
Association in the Anthem Blue Cross HMO network. You have
the right to designate any PCP who participates in the
network and who is available to accept you or your family
members. For children, you may designate a pediatrician as
the PCP. You do not need authorization to obtain access to
obstetrical or gynecological care from a health care
professional in the network who specializes in obstetrics or
gynecology. Your PCP manages all of your medical care, refers
you to specialists as needed, and can help you take advantage
of special wellness programs. If you do not list a PCP on your
enrollment form, Anthem Blue Cross will automatically assign
one to you within 30 miles from your home address. If you’re
not satisfied with Anthem Blue Cross’ selection, you should
call Anthem Blue Cross Customer Service at 800-289-2250 to
request a medical PCP change.
This plan is only available to California residents.
Kaiser HMO
Kaiser HMO benefits are payable only when you use Kaiser providers and facilities. You must select a primary care
physician (PCP) to manage your health care, including referrals to specialists. You have the right to designate any
PCP who participates in the network and who is available to accept you or your family members. For children,
you may designate a pediatrician as the PCP. You do not need authorization to obtain access to obstetrical or
gynecological care from a health care professional in the network who specializes in obstetrics or gynecology.
Kaiser will automatically assign a PCP for yourself and your enrolled family members. For information on how to
change your PCP, and for a list of PCPs, contact Kaiser. If you’d like a second opinion, you can ask to see another
Kaiser physician. You may change your Kaiser physician at any time for any reason.
With the Kaiser HMO, there are no deductibles and no claim forms. You pay a $15 co-pay for most services. The
annual out-of-pocket maximum is $1,500 per person and $3,000 per family. Worldwide emergency benefits are
available when you travel away from home.
This plan is only available to California residents.
*
Under the “Plus” benefits, you have the option to choose providers outside of the CaliforniaCare HMO network for certain outpatient
services and still receive limited benefits for those services. Refer to the section titled “Your Plus Benefits” in the CaliforniaCare HMO
Evidence of Coverage for details.
Anthem Blue Cross Guest
Membership Program
Your eligible dependents living outside
of California may be eligible to enroll
in HMO coverage with a partner Blue
Cross and Blue Shield plan under the
Guest Membership Program. The
program is for members who will
be temporarily residing outside of
California for a minimum of 90 days.
Call 800-827-6422 for a list of states
that participate in the program, verify
provider availability and request a
Guest Membership application.